Objectives To investigate the occurrence of postinfectious IBS in routine outpatient care, comparing different types of GI infection and its interaction with psychosomatic comorbidity. Design Retrospective cohort study using routinely collected claims data covering statutorily insured patients in Bavaria, Germany. Cases were defined as patients without prior record of functional intestinal disorder with a first-time diagnosis of GI infection between January 2005 and December 2013 and classed according to the type of infection. Each case was matched by age, sex and district of residence to a patient without history of GI infection. Prior psychological disorder (depression, anxiety or stress reaction disorder) was assessed in the 2 years prior to inclusion. Proportional hazards regression models were used to estimate the HRs for GI infection and psychological disorder. Chronic fatigue syndrome (CFS) was assessed as a comparator outcome. Results A total of 508 278 patients with first diagnosis of GI infection were identified, resulting in a matched cohort of 1 016 556 patients. All infection types were associated with an increased risk of IBS (HR: 2.19–4.25) and CFS (HR 1.35–1.82). Prior psychological disorder was a distinct risk factor for IBS (HR: 1.73) and CFS (HR: 2.08). Female sex was a further risk factor for both conditions. Conclusion Psychological disorder and GI infections are distinct risk factors for IBS. The high incidence of non-specific GI infection suggests that postinfectious IBS is a common clinical occurrence in primary care. Chronic fatigue is a further significant sequela of GI infection.

中文翻译：

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胃肠道感染后肠易激综合征和慢性疲劳的发生率：一项使用常规收集的索赔数据的人群研究

目的 调查常规门诊治疗中感染后 IBS 的发生情况，比较不同类型的 GI 感染及其与心身共病的相互作用。使用常规收集的索赔数据设计回顾性队列研究，涵盖德国巴伐利亚州的法定保险患者。病例定义为在 2005 年 1 月至 2013 年 12 月期间首次诊断为胃肠道感染且无功能性肠道疾病既往记录的患者，并根据感染类型进行分类。每个病例都按年龄、性别和居住地区与没有胃肠道感染史的患者相匹配。在纳入之前的 2 年内评估了先前的心理障碍（抑郁、焦虑或压力反应障碍）。比例风险回归模型用于估计胃肠道感染和心理障碍的 HR。慢性疲劳综合征 (CFS) 被评估为比较结果。结果 共纳入 508 278 名首次诊断为胃肠道感染的患者，匹配队列为 1 016 556 名患者。所有感染类型都与 IBS（HR：2.19-4.25）和 CFS（HR 1.35-1.82）风险增加有关。既往心理障碍是 IBS（HR：1.73）和 CFS（HR：2.08）的明显危险因素。女性是这两种情况的进一步危险因素。结论 心理障碍和胃肠道感染是IBS的独特危险因素。非特异性 GI 感染的高发率表明感染后 IBS 是初级保健中常见的临床事件。